POS0093 ASSESSMENT OF HISTOLOGICAL FEATURES OF CHRONICITY OF MINOR SALIVARY GLAND BIOPSY IN PATIENTS WITH PRIMARY SJOGREN’S SYNDROME
Authors: S. Garcia-Cirera, C. Galisteo, S. Retamozo, M. Moreno, E. Casado, M. Rusiñol Gonzalez, J. Gratacos-Masmitja, J. Calvet
Journal: Annals of the Rheumatic Diseases (2022)

Background The origin of the histological chronic inflammation of the salivary gland in patients with primary Sjogren’s Syndrome (pSS) is questionable. It is probably a consequence of both, the evolution of the disease itself and ageing Objectives This study aims to evaluate histological data of chronicity of minor salivary gland biopsy with clinical characteristics and time of evolution in a series of patients with pSS. Methods A cross-sectional study including 98 subjects fulfilling the ACR-EULAR 2017 classification criteria for pSS. All patients underwent a minor salivary gland biopsy requested as per clinical practice. We collected the age at diagnosis and at biopsy, xeroftalmia and xerostomia evolution time, and stimulated and unstimulated salivary flow as a clinical data. We informed the following features in the minor salivary gland biopsy: the focus score (positive if ≥ 1), atrophy, fibrosis and adiposity all graded in negative, mild, moderate, and severe stages according to pathological criteria. Results This study included 98 patients with pSS. the median of all recruited parameters are shown in Table 1. Only 2 patients presented severe fibrosis and adiposity, so we did not consider them for the analysis. Both, the age at diagnosis and at biopsy are significantly higher between none, mild and moderate stages in the three biopsy parameters. The age at biopsy increased in negative, mild, and moderate stages, in median, 10, 9 and 6 years in atrophy, fibrosis and adiposity respectively. Although more evolution time is observed in atrophy and fibrosis regarding classification categories, it does not reach statistical signification. Focus score is associated with atrophy as a high percentage in severe stage shows negative biopsy (78% vs 22%, p = 0.046) while in negative, mild, and moderate atrophy display a positive biopsy (61%, 73% and 64%, respectively). Furthermore, we observe a significant OR of 8.75 [1.7-68] for negative, 6 [1.25-44] in mild and 9.92 [1.8-80] in moderate compared to severe atrophy. Fibrosis and adiposity are not related to focus score. A low unstimulated salivary flow is observed in the atrophy and fibrosis stages, although differences are explained when compared negative with mild and moderate (3.5 vs 2 and 1.4 for atrophy and 3 vs 2 and 1.75 for fibrosis). Regarding adiposity, a lineal statistically significant association is observed for every stage (3.5, 1.65 and 0.7, p&lt; 0.001). No differences in the stimulated salivary flow are shown. Table 1. Description of variables included in the study. Categories N(%)Median(IQR) Age at diagnosis(years) 55.220 (51.097, 58.407) Age at biopsy (years) 57.719 (53.851, 61.333) Xerostomia (months) 19.614 (10.480, 35.121) Xeroftalmia (months) 21.487 (8.148, 38.735) Focus score (positive) 63 (64.3%) USF (ml/15 min) 2.000 (1.400, 3.000) SSF (ml/ 5min) 4.500 (3.000, 5.000) Atrophy Negative 28 (28.7%) Mild 37 (38.1%) Moderate 23 (23.7%) Severe 9 (9.3%) Fibrosis Negative 29 (30.5%) Mild 40 (42.1%) Moderate 26 (27.4%) Adiposity Negative 39 (41.1%) Mild 38 (40%) Moderate 18 (18.9%) USF: Unstimulated salivary flow, SSF: Stimulated salivary flow Conclusion An older age both, at diagnosis and at biopsy are associated with a severe stage of atrophy, fibrosis, and adiposity. Patient with severe atrophy shows less positive focus score, which might be noticed for biopsy interpretation Disclosure of Interests None declared